Invasive Klebsiella pneumoniae Infections in Community-Settings and Healthcare Settings

作者：Yue Qiu, Daojiong Lin, Yi Xu, Yibing Cheng, Fang Wang, Qingxiong Zhu, Chunhui Zhu, Chaomin Wan, Yu Zhu, Jianning Tong, Rui Li, Qionghua Zhou, Minxia Chen, Qing-Wen Shan, Zhiqiang Zhuo, Caihong Wang, Shiyong Zhao, Wen Song, Mei Zeng · 发表于：Infection and Drug Resistance · 年份：2021 · DOI：10.2147/idr.s315871 · 被引用次数：20 · 研究领域：Antibiotic Resistance in Bacteria、Pneumonia and Respiratory Infections、Neonatal and Maternal Infections

OBJECTIVE: (KP) infections in Chinese pediatric patients in hospital and community settings. METHODS: This retrospective study was conducted in the nine tertiary hospitals during 2016-2018. The 324 pediatric inpatients who had KP isolated from blood and cerebrospinal fluid and had complete medical records reviewed were included. We analyzed the risk factors, outcomes and antimicrobial resistance pattern of KP-infected patients based on comparison between healthcare-associated KP infections (HAI) and community-acquired infections. RESULTS: Of the 324 enrolled patients, 275 (84.9%) were clinically defined as HAI, including 175 (63.6%) neonates and 100 (36.4%) aged >28 days. The overall prevalence of CRKP was 38.2% (43.4% in HAI verse 8.7% in CAI, P <0.05). Prematurity (odds ratio (OR): 37.07, 95% CI: 8.29-165.84), hematologic malignancies (OR: 15.52, 95% CI: 1.89-127.14) and invasive mechanical ventilation (OR: 13.09, 95% CI: 1.66-103.56) were independent risk factors for HAI. Patients from rural area (OR: 1.94, 95% CI: 1.12-3.35), invasive mechanical ventilation (OR: 2.33, 95% CI: 1.25-4.33), antibiotic therapy prior to admission (OR: 2.33, 95% CI: 1.25-4.33) and prior hospital stay in the past 30 days (OR: 3.46, 95% CI: 1.87-6.41) were associated with healthcare-associated CRKP infections. Organ dysfunction was independently correlated with poor outcomes (OR: 2.92, 95% CI: 1.23-6.95). CONCLUSION: Pediatric invasive KP infections and high prevalence of CRKP infections largely ...